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	<title>Laughing Sherpa by Dr Miriam Korn, MD &#187; Psych 101</title>
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	<description>A Happy Guide for Healthy Living</description>
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		<title>Economics of Happiness</title>
		<link>http://laughingsherpa.ca/economics-of-happiness/</link>
		<comments>http://laughingsherpa.ca/economics-of-happiness/#comments</comments>
		<pubDate>Sun, 26 Oct 2014 07:56:00 +0000</pubDate>
		<dc:creator><![CDATA[Mia Korn]]></dc:creator>
				<category><![CDATA[Psych 101]]></category>
		<category><![CDATA[Uncategorized]]></category>

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		<description><![CDATA[<p>Historically, economists have said that well-being is a simple function of income. However, it has been found that once wealth reaches a subsistence level, its effectiveness as a generator of well-being is greatly diminished.[11]&#160;This paradox has been referred to as the&#160;Easterlin paradox.[1]&#160;Happiness economists hope to change the way governments view well-being and how to most [&#8230;]</p>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/economics-of-happiness/">Economics of Happiness</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
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				<content:encoded><![CDATA[<p>
<div style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; margin-bottom: 0.5em; margin-top: 0.5em;">Historically, economists have said that well-being is a simple function of income. However, it has been found that once wealth reaches a subsistence level, its effectiveness as a generator of well-being is greatly diminished.<sup style="font-size: 11px; line-height: 1; unicode-bidi: -webkit-isolate;"><a href="http://en.wikipedia.org/wiki/Happiness_economics#cite_note-ExplainingEconomics-11" style="background: none; color: #0b0080; text-decoration: none; white-space: nowrap;">[11]</a></sup>&nbsp;This paradox has been referred to as the&nbsp;<a href="http://en.wikipedia.org/wiki/Easterlin_paradox" style="background: none; color: #0b0080; text-decoration: none;" title="Easterlin paradox">Easterlin paradox</a>.<sup style="font-size: 11px; line-height: 1; unicode-bidi: -webkit-isolate;"><a href="http://en.wikipedia.org/wiki/Happiness_economics#cite_note-Graham-1" style="background: none; color: #0b0080; text-decoration: none; white-space: nowrap;">[1]</a></sup>&nbsp;Happiness economists hope to change the way governments view well-being and how to most effectively govern and allocate resources given this paradox.<sup style="font-size: 11px; line-height: 1; unicode-bidi: -webkit-isolate;"><a href="http://en.wikipedia.org/wiki/Happiness_economics#cite_note-Oswald-12" style="background: none; color: #0b0080; text-decoration: none; white-space: nowrap;">[12]</a></sup></div>
<div style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; margin-bottom: 0.5em; margin-top: 0.5em;">In 2010,&nbsp;<a href="http://en.wikipedia.org/wiki/Daniel_Kahneman" style="background: none; color: #0b0080; text-decoration: none;" title="Daniel Kahneman">Daniel Kahneman</a>&nbsp;and&nbsp;<a href="http://en.wikipedia.org/wiki/Angus_Deaton" style="background: none; color: #0b0080; text-decoration: none;" title="Angus Deaton">Angus Deaton</a>&nbsp;found that higher earners generally reported better life satisfaction, but people&#8217;s day-to-day emotional well-being only rose with earnings until a threshold annual income of $75,000.<sup style="font-size: 11px; line-height: 1; unicode-bidi: -webkit-isolate;"><a href="http://en.wikipedia.org/wiki/Happiness_economics#cite_note-13" style="background: none; color: #0b0080; text-decoration: none; white-space: nowrap;">[13]</a></sup></div>
<div style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; margin-bottom: 0.5em; margin-top: 0.5em;"><a href="http://en.wikipedia.org/wiki/Gregg_Easterbrook" style="background: none; color: #0b0080; text-decoration: none;" title="Gregg Easterbrook">Gregg Easterbrook</a>&nbsp;claims that even though wealth, or economic surplus, is more common today than in 1950, people are still as happy as they were 60 years ago.<sup style="font-size: 11px; line-height: 1; white-space: nowrap;">[<i><a href="http://en.wikipedia.org/wiki/Wikipedia:Citation_needed" style="background: none; color: #0b0080; text-decoration: none;" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (December 2011)">citation needed</span></a></i>]</sup>&nbsp;In polls taken by the National Opinion Research Center, about 1/3 Americans said they were really happy in 1950, since then the polls have been taken periodically, and the results have stayed about the same since then.</div>
<div style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; margin-bottom: 0.5em; margin-top: 0.5em;">Other factors have been suggested as making people happier than money.<sup style="font-size: 11px; line-height: 1; unicode-bidi: -webkit-isolate;"><a href="http://en.wikipedia.org/wiki/Happiness_economics#cite_note-MVH-6" style="background: none; color: #0b0080; text-decoration: none; white-space: nowrap;">[6]</a></sup>&nbsp;A short term course of psychological therapy is 32 times more cost effective at increasing happiness than simply increasing income.<sup style="font-size: 11px; line-height: 1; unicode-bidi: -webkit-isolate;"><a href="http://en.wikipedia.org/wiki/Happiness_economics#cite_note-14" style="background: none; color: #0b0080; text-decoration: none; white-space: nowrap;">[14]</a></sup><sup style="font-size: 11px; line-height: 1; unicode-bidi: -webkit-isolate;"><a href="http://en.wikipedia.org/wiki/Happiness_economics#cite_note-15" style="background: none; color: #0b0080; text-decoration: none; white-space: nowrap;">[15]</a></sup></div>
<div style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; margin-bottom: 0.5em; margin-top: 0.5em;">Scholars at the University of Virginia, University of British Columbia and Harvard University released a study in 2011 after examining numerous academic paper in response to an apparent contradiction: “When asked to take stock of their lives, people with more money report being a good deal more satisfied. But when asked how happy they are at the moment, people with more money are barely different than those with less.”&nbsp;</div>
<div style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; margin-bottom: 0.5em; margin-top: 0.5em;"></div>
<div style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; margin-bottom: 0.5em; margin-top: 0.5em;"></div>
<div style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; margin-bottom: 0.5em; margin-top: 0.5em;"></div>
<div style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; margin-bottom: 0.5em; margin-top: 0.5em;">Published in the&nbsp;<i>Journal of Consumer Psychology</i>, the study is entitled&nbsp;</div>
<div style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; margin-bottom: 0.5em; margin-top: 0.5em;"><i><b>“If Money Doesn’t Make You Happy, Then You Probably Aren’t Spending It Right”</b></i>:</div>
<div style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; margin-bottom: 0.5em; margin-top: 0.5em;"></div>
<ul style="background-color: white; color: #252525; font-family: sans-serif; font-size: 14px; line-height: 22.3999996185303px; list-style-image: url(data:image/png; margin: 0.3em 0px 0px 1.6em; padding: 0px;">
<li style="margin-bottom: 0.1em;">Spend money on “experiences” rather than goods.</li>
<li style="margin-bottom: 0.1em;">Donate money to others, including charities, rather than spending it solely on oneself.</li>
<li style="margin-bottom: 0.1em;">Spend small amounts of money on many small, temporary pleasures rather than less often on larger ones.</li>
<li style="margin-bottom: 0.1em;">Don’t spend money on “extended warranties and other forms of overpriced insurance.&#8221;</li>
<li style="margin-bottom: 0.1em;">Adjust one&#8217;s mindset to “pay now, consume later,” instead of “consume now, pay later.”</li>
<li style="margin-bottom: 0.1em;">Exercise&nbsp;<a href="http://en.wiktionary.org/wiki/circumspect" style="background: none; color: #663366; text-decoration: none;" title="wikt:circumspect">circumspection</a>&nbsp;about the day-to-day consequences of a purchase beforehand.</li>
<li style="margin-bottom: 0.1em;">Rather than buying products that provide the &#8220;best deal,&#8221; make purchases based on what will facilitate well-being.</li>
<li style="margin-bottom: 0.1em;">Seek out the opinions of other people who have prior experience of a product before purchasing it.<sup style="font-size: 11px; line-height: 1; unicode-bidi: -webkit-isolate;"><a href="http://en.wikipedia.org/wiki/Happiness_economics#cite_note-16" style="background: none; color: #0b0080; text-decoration: none; white-space: nowrap;">[16]</a></sup></li>
<li></li>
</ul>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/economics-of-happiness/">Economics of Happiness</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
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		<title>10 Habits of Happy People</title>
		<link>http://laughingsherpa.ca/10-habits-of-happy-people/</link>
		<comments>http://laughingsherpa.ca/10-habits-of-happy-people/#comments</comments>
		<pubDate>Sun, 26 Oct 2014 07:39:00 +0000</pubDate>
		<dc:creator><![CDATA[Mia Korn]]></dc:creator>
				<category><![CDATA[Psych 101]]></category>
		<category><![CDATA[Uncategorized]]></category>

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		<description><![CDATA[<p>10 Signs Of Happiness Though it may come in different forms for different people, most human beings are in pursuit of the same thing: happiness. It may be closer than you imagined.&#160; By Meredith Dault for readersdigestca &#160; 1 &#160; For some, happiness can be a pesky, fair-weathered friend, forever on the loose. The fact [&#8230;]</p>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/10-habits-of-happy-people/">10 Habits of Happy People</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
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				<content:encoded><![CDATA[<h1 style="background-color: white; font-family: Lora, Georgia, serif !important; font-size: 30px !important; line-height: 32px !important; margin: 0px 0px 17px; padding: 10px 0px 6px; position: relative; text-transform: capitalize;">10 Signs Of Happiness</h1>
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<div style="color: rgb(0, 0, 0) !important; font-family: Lato, sans-serif; font-size: 18px; line-height: 22px !important; margin-bottom: 14px;">Though it may come in different forms for different people, most human beings are in pursuit of the same thing: happiness. It may be closer than you imagined.&nbsp;</div>
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<p><span style="background-color: white; color: rgba(0, 0, 0, 0.65098) !important; display: block; font-family: Lato, Verdana, sans-serif !important; font-size: 12px !important; line-height: 24px; margin: 0px 0px 5px;">By Meredith Dault for readersdigestca</span>
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<div style="background-color: white; color: #1a1a1a; font-family: Merriweather, Georgia, serif; font-size: 14px; line-height: 20px; margin-bottom: 14px; word-spacing: -1px;">For some, happiness can be a pesky, fair-weathered friend, forever on the loose. The fact is that you have everything you need for happy living right now! Seeing it may simply be a matter of tweaking your own thinking so that you can appreciate what you’ve already got. Look for these signs and say hello to happiness!</div>
<h3 style="background-color: white; font-family: Lato, Verdana, sans-serif; font-size: 14px; line-height: 16px; margin: 0px 0px -1px; padding: 0px;">1. You Live Your Life With Integrity</h3>
<div style="background-color: white; color: #1a1a1a; font-family: Merriweather, Georgia, serif; font-size: 14px; line-height: 20px; margin-bottom: 14px; word-spacing: -1px;">Living a life that’s in line with your own values and belief is important for happiness.&nbsp; “That means that the things you say you believe in are the things you do,” says “Happy Guy” David Leonhardt, the author of&nbsp;<a false="" href="http://www.thehappyguy.com/happiness-self-help-book.html" return="" style="color: black; text-decoration: none;">Climb Your Stairway to Heaven: the Nine Habits of Maximum Happiness</a>.&nbsp; For example, if you value the environment, do you mind your carbon footprint? Or if family is important, do you make time for them? Figure out what’s important and live your life accordingly.</div>
<h3 style="background-color: white; font-family: Lato, Verdana, sans-serif; font-size: 14px; line-height: 16px; margin: 0px 0px -1px; padding: 0px;">2. You’ve Embraced Living In The Moment</h3>
<div style="background-color: white; color: #1a1a1a; font-family: Merriweather, Georgia, serif; font-size: 14px; line-height: 20px; margin-bottom: 14px; word-spacing: -1px;">You’re fully awake and aware, and concentrate your energies on enjoying the present, rather than worrying about the past or the future. “All we have is right now,” says Michelle Keeley, an executive leadership coach with&nbsp;<a false="" href="http://www.fruitionstrategies.com/" return="" style="color: black; text-decoration: none;">Fruition Strategies</a>, “and life is just made up of a series of moments.”&nbsp; Enjoy them.</div>
<h3 style="background-color: white; font-family: Lato, Verdana, sans-serif; font-size: 14px; line-height: 16px; margin: 0px 0px -1px; padding: 0px;">3. You Express Gratitude Regularly</h3>
<div style="background-color: white; color: #1a1a1a; font-family: Merriweather, Georgia, serif; font-size: 14px; line-height: 20px; margin-bottom: 14px; word-spacing: -1px;">Being grateful for the things you have—and sharing that gratitude—will lead to feelings of satisfaction and happiness.&nbsp; “When you’re performing an act of kindness or giving someone a compliment, you can actually feel an energy shift in your body,” says Todd Keeley, Michelle’s brother and business partner. Seek that feeling out more often.</div>
<h3 style="background-color: white; font-family: Lato, Verdana, sans-serif; font-size: 14px; line-height: 16px; margin: 0px 0px -1px; padding: 0px;">4. Your Work Satisfies You</h3>
<div style="background-color: white; color: #1a1a1a; font-family: Merriweather, Georgia, serif; font-size: 14px; line-height: 20px; margin-bottom: 14px; word-spacing: -1px;">If you find satisfaction in the things you do, then you’re well on your way to living a happy life. “The more meaningfully we’re engaged and the more we believe that what we’re doing is meaningful, the more happy we are,” says David Mensink, a psychologist with the&nbsp;<a false="" href="http://counsellingservices.dal.ca/" return="" style="color: black; text-decoration: none;">student counseling centre at Dalhousie University</a>.&nbsp; And it doesn’t necessarily have to be linked to a career.&nbsp; “For example,” says Mensink, “you can be meaningfully engaged in caring for children,”</div>
<h3 style="background-color: white; font-family: Lato, Verdana, sans-serif; font-size: 14px; line-height: 16px; margin: 0px 0px -1px; padding: 0px;">5. You Enjoy Harmonious Relationships</h3>
<div style="background-color: white; color: #1a1a1a; font-family: Merriweather, Georgia, serif; font-size: 14px; line-height: 20px; margin-bottom: 14px; word-spacing: -1px;">Whether it’s at work or at play, being at peace with yourself and the world around is a surefire way to find happiness. Practice respect and patience as you go about your day, whether you’re interacting with family, co-workers or with your partner.</div>
<h3 style="background-color: white; font-family: Lato, Verdana, sans-serif; font-size: 14px; line-height: 16px; margin: 0px 0px -1px; padding: 0px;">6. You Keep Your Inner Critic On ‘Mute’</h3>
<div style="background-color: white; color: #1a1a1a; font-family: Merriweather, Georgia, serif; font-size: 14px; line-height: 20px; margin-bottom: 14px; word-spacing: -1px;">If you’ve got a little voice in your head telling you you’re never good enough and you’re never satisfied, then odds are good you won’t find happiness either. “Choose to let go of negative feelings and thoughts,” says Todd Keeley, “You won’t find happiness until you do.”</div>
<h3 style="background-color: white; font-family: Lato, Verdana, sans-serif; font-size: 14px; line-height: 16px; margin: 0px 0px -1px; padding: 0px;">7. You Aren’t Afraid Of Change</h3>
<div style="background-color: white; color: #1a1a1a; font-family: Merriweather, Georgia, serif; font-size: 14px; line-height: 20px; margin-bottom: 14px; word-spacing: -1px;">Recognize that change is constant and you’ll be more ready to embrace happiness. “Then choose to respond to life, rather than react to it,” says Michelle Keeley.&nbsp; You’ll feel more in control and will be better able to adapt.&nbsp; Stay open to the opportunities change can bring.</div>
<h3 style="background-color: white; font-family: Lato, Verdana, sans-serif; font-size: 14px; line-height: 16px; margin: 0px 0px -1px; padding: 0px;">8. You Enjoy The Simple Things</h3>
<div style="background-color: white; color: #1a1a1a; font-family: Merriweather, Georgia, serif; font-size: 14px; line-height: 20px; margin-bottom: 14px; word-spacing: -1px;">Taking pleasure in small things will help you build a big picture of happiness. Take time to enjoy a well-cooked meal, a beautiful painting or a spring bulb poking up through the earth.</div>
<h3 style="background-color: white; font-family: Lato, Verdana, sans-serif; font-size: 14px; line-height: 16px; margin: 0px 0px -1px; padding: 0px;">9. You Give Back</h3>
<div style="background-color: white; color: #1a1a1a; font-family: Merriweather, Georgia, serif; font-size: 14px; line-height: 20px; margin-bottom: 14px; word-spacing: -1px;">Happiness is contagious, so make sure you spread it around. “Giving back to others and sharing is the ultimate way to inspire happiness in your life,” says Michelle Keeley.&nbsp; “Because what you give out will come back to you ten-fold.”&nbsp; Whether you volunteer in your community or share your smiles—it all counts.</div>
<h3 style="background-color: white; font-family: Lato, Verdana, sans-serif; font-size: 14px; line-height: 16px; margin: 0px 0px -1px; padding: 0px;">10. You Don’t Take Life Too Seriously</h3>
<div style="background-color: white; color: #1a1a1a; font-family: Merriweather, Georgia, serif; font-size: 14px; line-height: 20px; margin-bottom: 14px; word-spacing: -1px;">Having a sense of humour can help you keep things in perspective. Make sure your life is filled with plenty of laughter!</div>
<div>Reader&#8217;s Digest</div>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/10-habits-of-happy-people/">10 Habits of Happy People</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
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		<title>Serotonin   Dopaimine  : Physiological Indicators of Mood</title>
		<link>http://laughingsherpa.ca/serotonin-dopaimine-physiological-indicators-of-mood/</link>
		<comments>http://laughingsherpa.ca/serotonin-dopaimine-physiological-indicators-of-mood/#comments</comments>
		<pubDate>Sun, 26 Oct 2014 07:38:00 +0000</pubDate>
		<dc:creator><![CDATA[Mia Korn]]></dc:creator>
				<category><![CDATA[Psych 101]]></category>
		<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://laughingsherpa.ca/serotonin-dopaimine-physiological-indicators-of-mood/</guid>
		<description><![CDATA[<p>Higher levels of serotonin are correlated with increased happiness and decreased anxiety.&#160;Dopamine also contributes to good mood, and in addition causes an increase in&#160;activity and willpower.&#160;Both serotonin and dopamine show decreased levels in&#160;depression.However, it is important not just to look at general levels of the neurotransmitter,&#160;but to also consider&#160;which parts of the brain show decreased [&#8230;]</p>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/serotonin-dopaimine-physiological-indicators-of-mood/">Serotonin   Dopaimine  : Physiological Indicators of Mood</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
]]></description>
				<content:encoded><![CDATA[<p><span style="background-color: #fdfdfd; color: #111111; font-family: 'Helvetica Neue', Arial, sans-serif; font-size: 14px; line-height: 19px;">Higher levels of <b>serotonin </b>are correlated with increased happiness and decreased anxiety.&nbsp;</span><br /><span style="background-color: #fdfdfd; color: #111111; font-family: 'Helvetica Neue', Arial, sans-serif; font-size: 14px; line-height: 19px;"><b>Dopamine</b> also contributes to good mood, and in addition causes an increase in&nbsp;</span><br /><span style="background-color: #fdfdfd; color: #111111; font-family: 'Helvetica Neue', Arial, sans-serif; font-size: 14px; line-height: 19px;">activity and willpower.&nbsp;</span><br /><span style="background-color: #fdfdfd; color: #111111; font-family: 'Helvetica Neue', Arial, sans-serif; font-size: 14px; line-height: 19px;"><br /></span><span style="background-color: #fdfdfd; color: #111111; font-family: 'Helvetica Neue', Arial, sans-serif; font-size: 14px; line-height: 19px;">Both serotonin and dopamine show decreased levels in&nbsp;</span><span style="color: #111111; font-family: Helvetica Neue, Arial, sans-serif;"><span style="font-size: 14px; line-height: 19px;">depression.</span></span><br /><span style="background-color: #fdfdfd; color: #111111; font-family: 'Helvetica Neue', Arial, sans-serif; font-size: 14px; line-height: 19px;">However, it is important not just to look at general levels of the neurotransmitter,&nbsp;</span><br /><span style="background-color: #fdfdfd; color: #111111; font-family: 'Helvetica Neue', Arial, sans-serif; font-size: 14px; line-height: 19px;">but to also consider&nbsp;</span><strong style="background-color: #fdfdfd; border: 0px; color: #111111; font-family: 'Helvetica Neue', Arial, sans-serif; font-size: 14px; line-height: 19px; margin: 0px; padding: 0px; vertical-align: baseline;">which parts of the brain show decreased neurotransmitter levels.&nbsp;</strong><br /><strong style="background-color: #fdfdfd; border: 0px; color: #111111; font-family: 'Helvetica Neue', Arial, sans-serif; font-size: 14px; line-height: 19px; margin: 0px; padding: 0px; vertical-align: baseline;">Depression correlates with decreased serotonin and dopamine levels in the&nbsp;</strong><br /><strong style="background-color: #fdfdfd; border: 0px; color: #111111; font-family: 'Helvetica Neue', Arial, sans-serif; font-size: 14px; line-height: 19px; margin: 0px; padding: 0px; vertical-align: baseline;">amygdala, thalamus, and hyppocampus.</strong></p>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/serotonin-dopaimine-physiological-indicators-of-mood/">Serotonin   Dopaimine  : Physiological Indicators of Mood</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
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		<title>Bipolar Disorder Demystified</title>
		<link>http://laughingsherpa.ca/bipolar-disorder-demystified/</link>
		<comments>http://laughingsherpa.ca/bipolar-disorder-demystified/#comments</comments>
		<pubDate>Sat, 04 Aug 2012 07:23:00 +0000</pubDate>
		<dc:creator><![CDATA[Mia Korn]]></dc:creator>
				<category><![CDATA[Psych 101]]></category>
		<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://laughingsherpa.ca/bipolar-disorder-demystified/</guid>
		<description><![CDATA[<p>Highs Clients often say they have mood swings and&#160; wonder if they have&#160;bipolar disorder. &#160; They believe their&#160;episodes of&#160;hyperactivity&#160;are &#8220;mania&#8221;. &#160; &#160;&#160; As described below,&#160;Diagnostic Statistics Manual (DSM) -IV &#160; defines specific criteria for&#160; mania &#160;and &#160;hypomania. &#160; A few hours or day of elevated mood / high energy&#160; does not fit the diagnosis. &#160;Also, [&#8230;]</p>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/bipolar-disorder-demystified/">Bipolar Disorder Demystified</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
]]></description>
				<content:encoded><![CDATA[<p>
<div><span style="font-family: Trebuchet MS, sans-serif; font-size: x-large;"><i><b>Highs</b></i></span></div>
<div><span style="font-family: Trebuchet MS, sans-serif; font-size: x-large;"><i><b><br /></b></i></span></div>
<div><o:p><span style="font-family: Trebuchet MS, sans-serif;">Clients often say they have mood swings and&nbsp;</span></o:p></div>
<div><o:p><span style="font-family: Trebuchet MS, sans-serif;">wonder if they have&nbsp;</span></o:p><span style="font-family: 'Trebuchet MS', sans-serif;">bipolar disorder. &nbsp;</span></div>
<div><span style="font-family: 'Trebuchet MS', sans-serif;">They believe their&nbsp;</span><span style="font-family: 'Trebuchet MS', sans-serif;">episodes of&nbsp;</span><span style="font-family: 'Trebuchet MS', sans-serif;">hyperactivity</span><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;are &#8220;mania&#8221;. &nbsp; &nbsp;&nbsp;</span></div>
<div><o:p><span style="font-family: Trebuchet MS, sans-serif;">As described below,&nbsp;</span></o:p><span style="font-family: 'Trebuchet MS', sans-serif;">Diagnostic Statistics Manual (DSM) -IV &nbsp;</span></div>
<div><span style="font-family: 'Trebuchet MS', sans-serif;">defines <b>specific criteria</b> for&nbsp;</span></div>
<div><o:p><span style="font-family: Trebuchet MS, sans-serif;"><i style="font-weight: bold;">mania &nbsp;</i>and <b>&nbsp;</b></span></o:p><span style="font-family: 'Trebuchet MS', sans-serif; font-style: italic; font-weight: bold;">hypomania. &nbsp;</span></div>
<div><span style="font-family: 'Trebuchet MS', sans-serif;"><br /></span></div>
<div><span style="font-family: 'Trebuchet MS', sans-serif;">A few hours or day of elevated mood / high energy&nbsp;</span></div>
<div><span style="font-family: 'Trebuchet MS', sans-serif;">does not fit the diagnosis. &nbsp;Also, these episodes are&nbsp;</span></div>
<div><span style="font-family: 'Trebuchet MS', sans-serif;">not</span><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;driven by situation &nbsp;<i>(eg. &nbsp;staying up all night to</i></span></div>
<div><span style="font-family: 'Trebuchet MS', sans-serif;"><i>complete a project)</i> &nbsp;or anxiety. &nbsp;&nbsp;</span></div>
<div></div>
<div><span style="font-family: Trebuchet MS, sans-serif;"><b>Manic Episodes significantly interfere with daily functioning,&nbsp;</b></span></div>
<div><span style="font-family: Trebuchet MS, sans-serif;">while <b>Hypomanic Episodes may not impair functioning. &nbsp;</b></span></div>
<div><span style="font-family: Trebuchet MS, sans-serif;"><b>A </b>mood stabilizer can help treat these episodes. &nbsp;</span></div>
<div><span style="font-family: 'Trebuchet MS', sans-serif;"><br /></span></div>
<div><span style="font-family: 'Trebuchet MS', sans-serif;"><br /></span></div>
<div></div>
<div><span style="font-family: Trebuchet MS, sans-serif;"><b><span style="font-size: x-large;">Manic Episode</span></b><o:p></o:p></span></div>
<div></div>
<div style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -18.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">A.<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp; </span>A distinct period of abnormally and <b>persistently elevated, expansive, or irritable mood</b>, lasting <b><i>at least 1 week </i>(</b>or any duration if hospitalization is necessary).<o:p></o:p></span></div>
<div style="margin-left: 18.0pt;"></div>
<div style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -18.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">B.<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp; </span>During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is irritable) and have been present to a significant degree:</span></div>
<div style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -18.0pt;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<div style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -18.0pt;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div>
<div style="margin-left: 45pt; text-indent: -24pt;"><span style="font-family: Trebuchet MS, sans-serif;">(1)<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp;</span>inflated self-esteem or&nbsp;<b>grandiosity</b><o:p></o:p></span></div>
<div style="margin-left: 45pt; text-indent: -24pt;"><span style="font-family: Trebuchet MS, sans-serif;">(2)<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp;</span>decreased need for&nbsp;<b>sleep</b>&nbsp;<i>(eg. feels rested after only 3 hours of sleep)</i><o:p></o:p></span></div>
<div style="margin-left: 45pt; text-indent: -24pt;"><span style="font-family: Trebuchet MS, sans-serif;">(3)<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp;</span>more&nbsp;<b>talkative</b>&nbsp;than usual or pressure to keep talking<o:p></o:p></span></div>
<div style="margin-left: 45pt; text-indent: -24pt;"><span style="font-family: Trebuchet MS, sans-serif;">(4)<span style="font-size: 7pt;">&nbsp;&nbsp;<b>&nbsp;&nbsp;</b></span><i><b>flight of ideas</b></i>&nbsp;or subjective experience that&nbsp;<b>thoughts are racing</b><o:p></o:p></span></div>
<div style="margin-left: 45pt; text-indent: -24pt;"><span style="font-family: Trebuchet MS, sans-serif;">(5)<span style="font-size: 7pt;">&nbsp;&nbsp;<b>&nbsp;&nbsp;</b></span><b>distractibility</b>&nbsp;<i>(ie. attention too easily drawn to unimportant or&nbsp;</i></span></div>
<div style="margin-left: 45pt; text-indent: -24pt;"><span style="font-family: Trebuchet MS, sans-serif;"><i>&nbsp; &nbsp; &nbsp; &nbsp;irrelevant external stimuli)</i><o:p></o:p></span></div>
<div style="margin-left: 45pt; text-indent: -24pt;"><span style="font-family: Trebuchet MS, sans-serif;">(6)<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp;</span>increase in&nbsp;<b>goal-directed activity</b>&nbsp;(either socially, at work or school, or sexually) or psychomotor agitation<o:p></o:p></span></div>
<div style="margin-left: 45pt; text-indent: -24pt;"><span style="font-family: Trebuchet MS, sans-serif;">(7)<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp;</span>excessive involvement in&nbsp;<b>pleasurable activities</b>&nbsp;that have a high potential for painful consequences&nbsp;<i>(eg. the person engages in unrestrained buying sprees, sexual indiscretions or foolish business investments)</i></span></div>
<div></div>
<div></div>
<div><b><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></b></div>
<div><b><span style="font-family: Trebuchet MS, sans-serif;"><span style="font-size: x-large;">Hypomanic Episode</span><o:p></o:p></span></b></div>
<div></div>
<div style="margin-left: 21.0pt; mso-add-space: auto; mso-list: l3 level1 lfo3; text-indent: -21.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">A.<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>A distinct period of persistently <b>elevated, expansive, or irritable mood,&nbsp;</b></span></div>
<div style="margin-left: 21.0pt; mso-add-space: auto; mso-list: l3 level1 lfo3; text-indent: -21.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">&nbsp; &nbsp; &nbsp; &nbsp;lasting throughout <b><i>at least 4 days</i></b>, that is clearly different from the&nbsp;</span></div>
<div style="margin-left: 21.0pt; mso-add-space: auto; mso-list: l3 level1 lfo3; text-indent: -21.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">&nbsp; &nbsp; &nbsp; &nbsp;usual nondepressed mood.<o:p></o:p></span></div>
<div style="margin-left: 21.0pt; mso-add-space: auto;"></div>
<div style="margin-left: 21.0pt; mso-add-space: auto; mso-list: l3 level1 lfo3; text-indent: -21.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">B.<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:<o:p></o:p></span></div>
<div style="margin-left: 21.0pt;"></div>
<div style="margin-left: 45.0pt; mso-add-space: auto; mso-list: l2 level1 lfo4; text-indent: -24.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">(1)<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp; </span>inflated self-esteem or <b>grandiosity</b><o:p></o:p></span></div>
<div style="margin-left: 45.0pt; mso-add-space: auto; mso-list: l2 level1 lfo4; text-indent: -24.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">(2)<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp; </span>decreased need for <b>sleep</b> <i>(eg. feels rested after only 3 hours of sleep)</i><o:p></o:p></span></div>
<div style="margin-left: 45.0pt; mso-add-space: auto; mso-list: l2 level1 lfo4; text-indent: -24.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">(3)<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp; </span>more <b>talkative</b> than usual or pressure to keep talking<o:p></o:p></span></div>
<div style="margin-left: 45.0pt; mso-add-space: auto; mso-list: l2 level1 lfo4; text-indent: -24.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">(4)<span style="font-size: 7pt;">&nbsp; <b>&nbsp; </b></span><i><b>flight of ideas</b></i> or subjective experience that <b>thoughts are racing</b><o:p></o:p></span></div>
<div style="margin-left: 45.0pt; mso-add-space: auto; mso-list: l2 level1 lfo4; text-indent: -24.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">(5)<span style="font-size: 7pt;">&nbsp;&nbsp;<b>&nbsp; </b></span><b>distractibility</b> <i>(ie. attention too easily drawn to unimportant or&nbsp;</i></span></div>
<div style="margin-left: 45.0pt; mso-add-space: auto; mso-list: l2 level1 lfo4; text-indent: -24.0pt;"><span style="font-family: Trebuchet MS, sans-serif;"><i>&nbsp; &nbsp; &nbsp; &nbsp;irrelevant external stimuli)</i><o:p></o:p></span></div>
<div style="margin-left: 45.0pt; mso-add-space: auto; mso-list: l2 level1 lfo4; text-indent: -24.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">(6)<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp; </span>increase in <b>goal-directed activity</b> (either socially, at work or school, or sexually) or psychomotor agitation<o:p></o:p></span></div>
<div style="margin-left: 45.0pt; mso-add-space: auto; mso-list: l2 level1 lfo4; text-indent: -24.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">(7)<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp; </span>excessive involvement in <b>pleasurable activities</b>that have a high potential for painful consequences <i>(eg. the person engages in unrestrained buying sprees, sexual indiscretions or foolish business investments)</i><o:p></o:p></span></div>
<div></div>
<div style="margin-left: 21.0pt; mso-add-space: auto; mso-list: l3 level1 lfo3; text-indent: -21.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">C.<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>The episode is associated with an unequivocal <b>change in functioning that is uncharacteristic of the person </b>when not symptomatic<o:p></o:p></span></div>
<div style="margin-left: 21.0pt; mso-add-space: auto;"></div>
<div style="margin-left: 21.0pt; mso-add-space: auto; mso-list: l3 level1 lfo3; text-indent: -21.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">D.<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>The disturbance in mood and the change in functioning are <b>observable by others.<o:p></o:p></b></span></div>
<div></div>
<div style="margin-left: 21.0pt; mso-add-space: auto; mso-list: l3 level1 lfo3; text-indent: -21.0pt;"><span style="font-family: Trebuchet MS, sans-serif;">E.<span style="font-size: 7pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>The episode is <b>not severe enough to cause marked impairment</b> in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features.<o:p></o:p></span></div>
<div></div>
<div><span style="font-family: Trebuchet MS, sans-serif;"><i><b>Note:</b>&nbsp; Hypomanic-like episodes that are clearly caused by somatic&nbsp;</i></span></div>
<div><span style="font-family: Trebuchet MS, sans-serif;"><i>anti-depressant treatment (e.g., medication, electroconvulsive therapy, light therapy)&nbsp;</i></span></div>
<div><span style="font-family: Trebuchet MS, sans-serif;"><i>do not count toward a diagnosis of Bipolar II Disorder.</i></span><o:p></o:p><br /><span style="font-family: Trebuchet MS, sans-serif;"><i><br /></i></span><br /><span style="font-family: Trebuchet MS, sans-serif;"><i><br /></i></span><br /><span style="font-family: Trebuchet MS, sans-serif;"><i><br /></i></span><br /><span style="font-family: Trebuchet MS, sans-serif;"><i><br /></i></span></div>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/bipolar-disorder-demystified/">Bipolar Disorder Demystified</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
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		<title>Intro to Psych</title>
		<link>http://laughingsherpa.ca/intro-to-psych/</link>
		<comments>http://laughingsherpa.ca/intro-to-psych/#comments</comments>
		<pubDate>Mon, 02 Apr 2012 05:59:00 +0000</pubDate>
		<dc:creator><![CDATA[Mia Korn]]></dc:creator>
				<category><![CDATA[Psych 101]]></category>
		<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://laughingsherpa.ca/intro-to-psych/</guid>
		<description><![CDATA[<p>The Teacup ID:&#160;&#160; 43 year old woman living with husband and three children.Master’s of Arts student, major in Russian Studies.&#160;&#160; History of bipolar II and delusional disorder. &#160;&#160;&#160; Annie prances through the door, her cowboy boots clomping and paisley skirt flouncing.&#160; She sits in the grey plastic chair facing me, transforming it into a throne.&#160; [&#8230;]</p>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/intro-to-psych/">Intro to Psych</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
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				<content:encoded><![CDATA[<div style="font-family: &quot;Trebuchet MS&quot;,sans-serif;">
<div style="text-align: center;"><b><span style="font-size: x-large;">The Teacup</span></b></div>
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<div style="font-family: &quot;Trebuchet MS&quot;,sans-serif;"><b><br /></b><br /><b><br /></b></div>
<div style="font-family: &quot;Trebuchet MS&quot;,sans-serif;"><b><br /></b></div>
<div style="font-family: &quot;Trebuchet MS&quot;,sans-serif; text-align: center;"><b><i>ID:&nbsp;&nbsp; 43 year old woman living with husband and three children.</i></b><br /><b><i>Master’s of Arts student, major in Russian Studies.&nbsp;&nbsp; </i></b><br /><b><i>History of bipolar II and delusional disorder.</i></b></div>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; Annie prances through the door, her cowboy boots clomping and paisley skirt flouncing.&nbsp; She sits in the grey plastic chair facing me, transforming it into a throne.&nbsp; Her outfit&#8217;s swirls of gold and red bring cheer to this little white room, this big grey building.&nbsp;&nbsp;&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; I like Annie.&nbsp;&nbsp; I like that she puts mascara on in her car, at stop lights.&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">I like her bold clothes and personality.&nbsp; I like her openness about her three year hiatus from med school and taking&nbsp; &#8220;drugs for my mood&#8221; which helped her get&nbsp; back to school, and decide to become a psychiatrist.&nbsp;&nbsp; I like that she is married to a TV star.&nbsp; I wonder if she ever worked as a fashion model.</span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;Is Dr. Mettha here yet?&#8221;, asks Annie.</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;No,&#8221; I reply.&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; She shakes a boot , leg over knee.&nbsp; &#8220;He&#8217;s probably getting Elizabeth.&#8221;&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;Must be,&#8221;&nbsp; I echo.&nbsp;&nbsp; From my seat of black&nbsp; plastic and chrome,&nbsp; I turn to the lone window, seeking a glimpse of sun and ocean.</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;It&#8217;ll be good for you to meet her.&nbsp; You can come to court with us, if it&#8217;s okay with her.&#8221;</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; I turn my head back to attention.&nbsp; &#8220;Sure. Sounds interesting.&#8221;</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;She&#8217;s definitely interesting.&nbsp;&nbsp;&nbsp; Been here since &#8211;&#8220;</span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; The door opens again, inviting in a woman with thick wavy brown hair cascading over her beige cable-knit cotton sweater atop a khaki skirt.&nbsp; Her feet don Birkenstocks.&nbsp; She must be in her late thirties . . . early forties?&nbsp; The wire glasses may be deceiving.&nbsp; She has pretty, soft facial features and full, coarse hair, like mine, but longer, half-way down her back.&nbsp;&nbsp;&nbsp; Behind her is Dr. Mettha, dapper in his charcoal suit and blue tie.&nbsp;&nbsp;&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; They stand in front of their chairs and sit in unison.&nbsp; Elizabeth sits below the window.&nbsp; Dr. Mettha sits between Annie and I.&nbsp; We face Elizabeth.&nbsp; Together, we form a lop-sided circle.</span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;How did it go yesterday?&#8221; inquires Annie.&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; Elizabeth describes her ferry ride across the harbour, exploration of used book stores and lingering in cafes.&nbsp; And yes, she stayed way from the university.&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; Dr. Metta is approving,&nbsp; &#8220;I&#8217;m glad you enjoyed your pass.&#8221;&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;The change of scenery felt so good after six months of being stuck here,&#8221; adds Elizabeth.&#8221;The same food.&nbsp; The same people.&nbsp; The same walls.&nbsp; Wandering around the same grass, each day.&nbsp; Can&#8217;t even get a decent cup of tea . . .&nbsp; just Styrofoam cups. . . &#8221;&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;Were you tempted to go see Vladmir?&#8221; asks Annie.</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;I almost went to his office. To confront him.&nbsp; Straighten things out.&nbsp; It had been so passionate,&#8221; her voice trails.&nbsp; She elaborates, describing a progression of innuendos, notes, phone calls and gifts.&nbsp; &#8220;All those nights sipping wine, reading Russian poetry by the fire.&nbsp; He seduced me and now he&#8217;s blaming it on me. Really manipulative.&#8221;</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; Another slimy professor guy, wielding his power, I assume.</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;But I stayed away,&#8221; she reassures us, as Annie and Dr. Metta nod their heads.</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;It&#8217;s important.&nbsp; Your court date is next week,&#8221; notes Annie. &#8220;We&#8217;ll be there, but you need to show you&#8217;re dependable.&nbsp; For your kids.&nbsp; Need to show you can take care of them.&nbsp; Your husband is making a case for full custody.&#8221;&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; Another bitter spouse using the children as pawns, I figure. </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; Elizabeth shakes her head and looks at the floor,&nbsp; &#8220;How did I get here?&#8221;</span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; Later, on the ward, we sit in the staff room, open binders on our laps, adding to the various caregivers&#8217; handwriting filling the lined pages.&nbsp; I enjoy this sunny room of (relatively cheerful) dilapidated turquoise vinyl sofas. </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; I peek out at the harbour from its windows, as I write about my time with Mrs. Kobash in the binder open in my lap.&nbsp;&nbsp; I have finally realized, during this fourth session, that the subject matter would likely never stray from&nbsp; her desire to leave, cook in her home&nbsp; and reunite with her allegedly mean husband.&nbsp; </span><span style="font-family: 'Trebuchet MS', sans-serif;">A lesson in Huntington&#8217;s disease and dementia.&nbsp;&nbsp; I have grown to like her disheveled grey hair, and our predictable conversations, though I&#8217;m distracted by the pieces of food stuck to her blouse.&nbsp; She rambles on until dismissed to the smoke room, a cave of human chimneys. For the smokers, it is a retreat, a place&nbsp; to relish a jolt of nicotine inspired pleasure and hide from the ever-present eyes of hospital staff.&nbsp;&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; Annie glances at my note, &#8220;Good, lots of quotes.&nbsp; . . .&#8221; She passes me her binder.&nbsp; It is opened to a pile of photocopied handwriting on unlined paper, &#8220;Elizabeth wrote these.&#8221;&nbsp; I scan the scrolling before me, &#8221; Vladmir, my love . . . &#8221; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; I am intrigued, but uneasy.&nbsp; Should I be reading&nbsp; reading this?&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">Does Elizabeth know that I, Annie, Dr. Methta &#8212; anyone looking at her chart &#8212; can read her letters?&nbsp;&nbsp; I flip the pages.&nbsp;&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; Delighted to be invited, I go along with Dr. Mettha, Annie and Elizabeth to court.&nbsp;&nbsp;&nbsp; Family court.&nbsp; She is defending her right to custody of her 5 year old daughter and 9 year old son.&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; Dr. Mettha is called to the stand.&nbsp;&nbsp; He affirms, in his testimony, Elizabeth had been &#8220;compliant&#8221; and &#8220;cooperative&#8221; and thus had become &#8220;stabilized&#8221; and &#8220;insightful&#8221; during her six month hospital sejourn.&nbsp; With the right &#8220;milieu&#8221; and medications, she has transformed.&nbsp; The diagnosis?&nbsp;&nbsp;&nbsp; &#8220;Delusional Disorder&#8221;, replies Dr. Mettha, &#8220;Erotomanic Type&#8221;. He pauses, &#8220;Rule Out Bipolar Disorder&#8221;.</span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; The lawyer presents the court with a list.&nbsp; A list of events.&nbsp; A list of times when Elizabeth &#8220;took off&#8221; in a car, &#8220;screamed at&#8221; her husband, spent $3000 on clothes in one afternoon, &#8220;threatened to jump in the harbor&#8221;, &#8220;made 82 telephone calls&#8221; to her Russian professor, bought an airplane ticket to Russia.&nbsp; This is news to me.&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; Elizabeth sits on the stand to answer the lawyer&#8217;s questions.&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">Spine straight, shoulders back, eyes alert, graced by tawny tresses.&nbsp; Her round spectacles, crisp white blouse and flowing blue skirt say earthy hippie lady.&nbsp; Her words say sophisticated novice intellectual.&nbsp;&nbsp; No sign of the wild woman described earlier.&nbsp;&nbsp; We are proud of her.&nbsp; She returns to our side</span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; The judge ends the session for lunch, and asks the attendees to reconvene&nbsp; at 1pm.&nbsp; We do as we are told, and return to our seats awaiting The Decision.&nbsp; The judge enters the room and sits behind his desk.&nbsp; He announces that in light of Ms. Mc Gregor&#8217;s current stable condition and positive prognosis, she is to have joint custody of her children once she is well enough to leave hospital and take appropriate care of them.&nbsp; The timing is to be determined by the collaborative discretion of health care and legal personnel.&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; I squeak with a restrained cheer.&nbsp;&nbsp;&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; We exit the building, surrounding Elizabeth with smiles, congratulations and praise for her poise. The jolly gaggle pile into Dr. Mettha&#8217;s van and head home, to the hospital.&nbsp; Triumphant.</span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; The path is clear now.&nbsp; Just a matter of a series of day passes.&nbsp; Then weekend passes until discharge.&nbsp; A couple more weeks or so.&nbsp; The last leg of a half year journey.&nbsp; We are cheerleaders eyeing the finish line.</span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; We meet again in The White Room, a week later.&nbsp; Annie presides, sparking the morning check-in.&nbsp; &#8220;How is it going?&#8221;</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;Good,&#8221; replies Jennifer. &#8220;Looking forward to seeing my kids.&#8221; She plans to have lunch tomorrow with her children, on her weekend pass.&nbsp; Then discharge, next week.&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; I meet Annie in the staff room on Monday.&nbsp; She hands me a two inch thick binder, the chronicle of Elizabeth&#8217;s stay.&nbsp; &#8220;Dr. Mettha got a call from the police.&nbsp; Elizabeth was arrested.&nbsp; She was throwing rocks at Vladmir&#8217;s window.&#8221;&nbsp; She sighs.&nbsp; &#8220;He&#8217;s pressing charges.&#8221; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; White Room again.&nbsp; Annie, Elizabeth, Dr. Mettha and I, again.&nbsp; &#8220;Did you see your children?&#8221;&nbsp; &#8220;No,&nbsp; I went straight to his house.&#8221;&nbsp; And thus, her sentence to this seaside prison is extended and her children are lost.&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; That night, I search in my cupboard and retrieve a white porcelain teacup.&nbsp; Its pink roses and gold rim had attracted my eye at a garage sale last year.&nbsp;&nbsp; I place it in a brown paper bag, along with a small glass teapot (another rummage retrieval) and half dozen tea bags.&nbsp;&nbsp;&nbsp; </span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; The next day, I hand the bag to a nurse.&nbsp; &#8220;Do you think it&#8217;s alright&nbsp; to give this to Elizabeth? &#8220;</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;I think it&#8217;s very nice.&#8221;&nbsp; Her colleagues nod. &#8220;Should I tell her who it&#8217;s from?&#8221;</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;No.&#8221;</span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp; </span></p>
<p><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; On the last day of my six week stint at the MT Hospital, I sit with </span><span style="font-family: 'Trebuchet MS', sans-serif;">Dr. Mettha,&nbsp; in his office.&nbsp; He shows me his paintings and latest books, among the clutter of his files.&nbsp; &#8220;You can&#8217;t give patients gifts.&#8221;</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;The nurses said it was okay.&nbsp; She didn&#8217;t know it was from me,&#8221;&nbsp; </span><span style="font-family: 'Trebuchet MS', sans-serif;">I envision Elizabeth clanking about the rolling lawn of NB Hospital grounds, gazing across the harbour.&nbsp; I hope she finds an oasis in her cup of tea.</span><br /><span style="font-family: 'Trebuchet MS', sans-serif;">&nbsp;&nbsp;&nbsp; &#8220;Have to be careful,&#8221;&nbsp; replies Dr. Metha. &#8220;You can&#8217;t get too involved.&#8221;</span></p>
<p>&nbsp;&nbsp;&nbsp; </p>
<p>&nbsp;&nbsp;&nbsp; <br />&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </p>
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<p>&nbsp;&nbsp;&nbsp; <br />&nbsp;&nbsp;&nbsp; <br />&nbsp;&nbsp;&nbsp; .</p>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/intro-to-psych/">Intro to Psych</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
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		<title>Getting hIgh can bring you down</title>
		<link>http://laughingsherpa.ca/getting-high-can-bring-you-down/</link>
		<comments>http://laughingsherpa.ca/getting-high-can-bring-you-down/#comments</comments>
		<pubDate>Fri, 12 Aug 2011 05:41:00 +0000</pubDate>
		<dc:creator><![CDATA[Mia Korn]]></dc:creator>
				<category><![CDATA[Psych 101]]></category>
		<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://laughingsherpa.ca/getting-high-can-bring-you-down/</guid>
		<description><![CDATA[<p>Many of my clients, including teachers,&#160;cooks, construction workers, nurses and university professors &#8230;report years, sometimes decades of regular, often daily, marijuana. &#160;They are generally surprised to learn they are exacerbating, if not causing, the anxiety, depression, insomnia and / or psychosis they suffer. &#160;It also interferes with treatment. &#160; When marijuana use is reduced or [&#8230;]</p>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/getting-high-can-bring-you-down/">Getting hIgh can bring you down</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
]]></description>
				<content:encoded><![CDATA[<p><span style="color: #004e0f; font-family: Molengo; font-size: 14px; line-height: 19px;"></span><br />
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<div style="line-height: 1.4; position: relative; width: 636px;">Many of my clients, including teachers,&nbsp;cooks, construction workers, nurses and university professors &#8230;report years, sometimes decades of regular, often daily, marijuana. &nbsp;They are generally surprised to learn they are exacerbating, if not causing, the anxiety, depression, insomnia and / or psychosis they suffer. &nbsp;It also interferes with treatment. &nbsp; When marijuana use is reduced or eliminated, many of their symptoms lessen or disappear.</p>
<p>Cannabis is a depressant. &nbsp;It is frequently used to alleviate uncomfortable thoughts and emotions, but paradoxically it can worsen and / or create these symptoms.&nbsp;A lot of cannabis, grown with the help of technology in recent years, &nbsp;is much more potent than in the past. It can contain almost twenty times more THC.</p>
<p>Also, some varieties breed out&nbsp;<b>cannabinoids</b>,&nbsp;a substance scientists speculate may protect against psychosis. For some, it can spark schizophrenia.* &nbsp;In the emergency room, young adults commonly present with a first episode of psychosis associated with marijuana use. &nbsp;Studies show that schizophrenia is up to four times more frequent among regular users of cannabis.
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<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">&#8220;I don&#8217;t consider marijuana a drug,&#8221; said a 20 year old client. &#8220;It should be legal.&#8221; &nbsp; &nbsp;There are many valid reasons to decriminalize cannabis. &nbsp;It can reduce physical pain and government regulation, as in Holland, can help control its composition. &nbsp;Yet, no matter it&#8217;s classification, legal status or intended use, marijuana is not harmless. &nbsp;</div>
<p>&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;*see David Suzuki&#8217;s&nbsp;<i><b>Downside of High</b></i>&nbsp;online
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		<title>Psychopharmacology 101</title>
		<link>http://laughingsherpa.ca/psychopharmacology-101/</link>
		<comments>http://laughingsherpa.ca/psychopharmacology-101/#comments</comments>
		<pubDate>Fri, 12 Aug 2011 05:36:00 +0000</pubDate>
		<dc:creator><![CDATA[Mia Korn]]></dc:creator>
				<category><![CDATA[Psych 101]]></category>
		<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://laughingsherpa.ca/psychopharmacology-101/</guid>
		<description><![CDATA[<p>Many clients, whether they be electricians, administrative assistants,&#160;professors,&#160;janitors, salespeople, lawyers&#8230;&#160;have misconceptions about medications. &#160;This sometimes gets in the way of proper treatment. &#160;Here is some information about commonly prescribed &#8220;anti-depressants&#8221;.After 4 &#8211; 6 weeks, these medications help improve mood as well as physical symptoms associated with depression&#160;such as insomnia, poor appetite / concentration / motivation. [&#8230;]</p>
<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/psychopharmacology-101/">Psychopharmacology 101</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
]]></description>
				<content:encoded><![CDATA[<p><span style="color: #004e0f; font-family: Molengo; font-size: 14px; line-height: 19px;"></span><br /><span style="color: #1cf349; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: x-large;"><span style="font-size: 22px;"><br /></span></span>
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<div style="line-height: 1.4; position: relative; width: 636px;"><b>Many clients, whether they be electricians, administrative assistants,&nbsp;</b><br /><b>professors,&nbsp;janitors, salespeople, lawyers&#8230;&nbsp;have misconceptions about medications. &nbsp;</b><br /><b>This sometimes gets in the way of proper treatment. &nbsp;</b><br /><b><br /></b><br /><b>Here is some information about commonly prescribed &#8220;a<span style="font-weight: normal;"><b>nti-depressants&#8221;.</b></span></b><br /><b><br /></b><br />After 4 &#8211; 6 weeks, these medications help improve mood as well as physical symptoms associated with depression&nbsp;such as insomnia, poor appetite / concentration / motivation. &nbsp;Most also alleviate anxiety.<br />It is important that a physician monitor medication and prescribe increased doses each 4 weeks,<br />until symptoms are significantly better or maximum dose is reached.</p>
<p><b><i>Serotonin Reuptake Inhibitors&nbsp;</i></b><br /><b><i><br /></i></b><br /><i>Celexa, Cipralex, Prozac, Zoloft, Luvox, Paxil</i></p>
<p>SRI&#8217;s inhibit the recycling of the neurotransmitter serotonin back into neurons.<br />Hence there is more serotonin available.</p>
<p><b>Serotonin and Norepinephrine&nbsp;Reuptake Inhibitors</b><br /><b><br /></b><br /><i>Effexor XR, &nbsp;Cymbalta, Pristiq</i></p>
<p>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">SNRI&#8217;s inhibit the recycling of the neurotransmitters serotonin and norepinephrine back into neurons.&nbsp;</div>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">Hence there is more serotonin and norepinephrine available. &nbsp;</div>
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<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><b><i>Norepinephrine and Dopamine Inhibitors</i></b></div>
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<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><i><br /></i></div>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><i>Wellbutrin &nbsp;XL and SR</i></div>
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<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">SNRI&#8217;s inhibit the recycling of the neurotransmitters &nbsp;norepinephrine and dopamine back into neurons.&nbsp;</div>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">Hence there is more seritonin and norepinephrine available. &nbsp;</div>
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<div>Because dopamine is stimulating,&nbsp;<i>Wellbutrin</i>&nbsp;can be particularly helpful to boost energy, concentration and motivation. &nbsp;However, is can worsen anxiety and insomnia. &nbsp;</div>
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<div>It can also be added to a SRI or SNRI to boost its anti-depressant&nbsp;and anti-anxiety effects,&nbsp;</div>
<div>particularly if the maximum dose is reached, providing only partial relief of symptoms or to alleviate</div>
<div>sexual side effects.</div>
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<div><i>Wellbutrin</i>&nbsp;is not associated with weight gain or sexual side effects. &nbsp;Hence, some clients prefer to&nbsp;</div>
<div>avoid the possibility of these side effects of SRI&#8217;s and SNRI&#8217;s. &nbsp;</div>
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<div><i>Wellbutrin&nbsp;</i>can be&nbsp;prescribed to treat Attention Deficit Hyperactivity Disorder or&nbsp;</div>
<div>help people to quite smoking. &nbsp;</div>
<p>Clients often tell me they have tried several medications in the past they &#8220;didn&#8217;t work&#8221;. &nbsp;Sometimes this is accurate, or the medications were discontinued due to intolerable side effects, but often they say they tried it for a few days or a week.</p>
<p>They often stop because they were ambivalent about taking medications, told by family or friends they shouldn&#8217;t take medications, or did not &nbsp;fill the prescription once they ran out of samples.</p>
<p><i>An adequate trial of a medication is at least &nbsp;6 weeks at a therapeutic dose.</i></p>
<p>Once adequate treatment is obtained, it is important to&nbsp;<i>continue medication for at least a year. &nbsp;</i>People sometimes discontinue their medications after few months of feeling better, and often have a relapse of &nbsp;symptoms.</p>
<p>Discuss any possible changes in medications with a physician. &nbsp;Some of the medications have uncomfortable withdrawl symptoms, when they are discontinued too abruptly.
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<p>The post <a rel="nofollow" href="http://laughingsherpa.ca/psychopharmacology-101/">Psychopharmacology 101</a> appeared first on <a rel="nofollow" href="http://laughingsherpa.ca">Laughing Sherpa by Dr Miriam Korn, MD</a>.</p>
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